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Wife’s Application for Husband’s Admission to the Permanent Diaconate
I. Personal Information
Date of Application
MM slash DD slash YYYY
Legal Name
*
First
Middle
Last
Preferred
Name of Spouse Applying to the Diaconate
First
Middle/maiden
Last
Preferred
Home Address
Street Address
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Home Phone
Cell Phone
Work Phone
Email Address
Date of Birth
MM slash DD slash YYYY
Age
Place of Birth
City
City
State
State
Country
Country
Are you a US Citizen?
Yes
No
Citizenship Country
Type Visa, expiration date, comments
Primary Language
Other Languages and Fluency
II. Employment History
Job Status
Select one
Employed Full-Time
Part-Time / Temporary
Self-Employed
Retired
Unemployed
Other
If "Other", describe
Present Occupation
Will your current employment interfere with your need to attend formation classes?
Yes
No
Briefly list other employment areas
What percent of the household income do you contribute?
Select one
Less than 10%
25%
50%
75%
Over 90%
III. Sacramental Information
Note: you are also required to submit a baptismal certificate with notations dated within six months of the application filing date.
Did you become Catholic as Adult (RCIA)
Yes
No
How many years have you been Catholic (enter zero if not Catholic)
If not Catholic, please describe religious beliefs
Additional Marriage Information (please list all prior marriages)
Spouse's Name
Date of Marriage
Date of Annulment
Diocese
Add
Remove
IV. Parish Information
Current Parish Name
Address
Pastor
Number of Years
Other Parishes of which you have been a member over the last five years, most recent first
Other Parish Name
Address
Pastor
Number of Years
Add
Remove
V. Family History
Please list parents, step-parents and guardians you had while growing up
Name
Relationship
Religion
Living
If you currently provide care, describe
Add
Remove
Please list children and dependents
Name
Relationship
Age
At Home
List any special needs or serious illnesses
Add
Remove
Please list any other persons currently living in your household
Name
Relationship
Age
Describe why person is in your home
Add
Remove
VI. Academic Information
List the highest academic degree obtained and field of study
Describe any additional training or skills you feel are significant
VII. Parish and Community Volunteer Service
Please list your most significant volunteer activities within the parish (extraordinary minister of communion, lector, catechist, music ministry, parish council, finance council, tribunal advocate, RCIA team, youth ministry...)
Parish Activity or Ministry
Years in Ministry
Still Active?
If not active, year stopped
When active, hrs per month
If applicable, list certification received or positions held
Add
Remove
Please list your most significant volunteer activities outside of the parish and in the community (soup kitchen, prison ministry, hospital ministry, guardian ad litem, homeless shelters, civic organizations, food pantries...)
Community Volunteer Activities
Years as volunteer
Still Active?
If not active, Year stopped
When active, hrs per Month
If applicable, list certification received or positions held
Add
Remove
VIII. Health Information
In addition to the health questions below, you will also be required to have your physician complete a separate medial report.
Please rate your general health
Select one
Poor
Fair
Good
Excellent
List any existing physical or mental limitations which you currently have
Have you ever received disability payments?
Yes
No
Have you been hospitalized in the last 5 years?
Yes
No
Have you ever experienced problems or been treated for chemical dependency, emotional / psychological difficulties, alcohol abuse, hypertension?
Yes
No
Please explain any of the above health question in which you answered "Yes"
IX. Personal Statements
Please select the phrase that best describes your attitude toward your husband applying to the Permanent Diaconate
Select one
Grave Reservations
Some Reservations
Neutral
Somewhat Encouraging
Strongly Encouraging
Please select the phrase that best describes how you feel the formation program will affect your marriage and family
Select one
Will be a net plus
No effect
Require some sacrifices
Some aspects may suffer
May cause some damage
Do you feel your husband has time to fully engage in the training program?
Yes
No
Wives of candidates must attend aspirancy sessions and formation classes with their husbands. Are you willing to make this commitment?
Yes
No
Do you give your husband full consent to apply and pursue his desire to become a Permanent Deacon?
Yes
No
Please explain any of the above questions in which you answered "No"
Please provide short answers to the questions below
1. Why do you think your husband wants to be a Permanent Deacon?
2. What background experiences would be of value to him as a Deacon?
3. What particular problems would have to be solved should your husband be accepted?
4. Should your husband be ordained as a Permanent Deacon, describe how you think your life will change?
5. If you could, what practices, traditions, and teachings within the Church would you work to improve, modify, or change?
Additional Comments? On your answers to any questions on this application, do you wish to make any additional comment or clarification
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